Alabama Cases Linked To Common Virus May Provide Clue

Topline

Nine Alabama children hospitalized with hepatitis also had adenovirus, a common disease that typically causes mild cold symptoms, strengthening the theory it is linked with the ongoing international hepatitis outbreak among children and possibly bringing investigators a step closer to understanding its origins, according to a study released Friday by the Centers for Disease Control and Prevention.

A scanning electron micrograph of adenovirus particles.

Cavallini James/BSIP/Universal Images Group via Getty Images

Key Facts

Of the nine Alabama children diagnosed with hepatitis and adenovirus, five were diagnosed with adenovirus type 41, a variant that sometimes causes hepatitis in children with immune disorders, but is not known to cause hepatitis among otherwise healthy children, the CDC said.

Six of the children tested positive for Epstein-Barr Virus (EBV), a common and typically mild pathogen nicknamed “mono,” though the EBV infections had apparently subsided before the children were diagnosed with hepatitis, implying that the EBV infections and hepatitis infections were not connected.

As of Friday, all nine children had either recovered or were recovering, including two who underwent liver transplants, the CDC said.

At least 169 child hepatitis cases have been identified across the U.S. and 11 European countries, World Health Organization Director-General Dr. Tedros Adhanom Ghebreyesus said Tuesday.

Of those at least 169 children with hepatitis, none had any of the viruses that typically cause hepatitis and at least 74 had adenovirus, though possible causes other than adenovirus are also under investigation, Ghebreyesus said.

Tangent

Hepatitis is a liver inflammation typically caused by the viruses hepatitis A, B, C, D and E. While hepatitis A is usually temporary, hepatitis B and C frequently cause cancer or permanent liver damage. However, the hepatitis viruses have not been linked to the outbreak of hepatitis disease.

What We Don’t Know

It’s possible that practicing social distancing during the Covid-19 pandemic has weakened children’s immune systems, leaving them vulnerable to diseases like hepatitis, Imperial College London liver researcher Simon Taylor-Robinson told Reuters. However, adenovirus has not yet been definitively identified as a cause of the outbreak, the CDC said.

Key Background

The outbreak, the causes of which are still not understood, was first reported by the U.K. Health Security Agency on April 6, after about 60 children under age 10 were diagnosed with the disease. Since then, cases have been reported across Europe, in Japan and the U.S. Cases have been identified in Alabama, North Carolina, Illinois and Wisconsin. At least one death has been reported in the international outbreak so far, the WHO said. Wisconsin public health officials announced Thursday they had also identified a death possibly connected to the outbreak, which would raise the cumulative death toll to two. Because adenovirus is not known to cause hepatitis in otherwise healthy children, its possible link to the outbreak has puzzled scientists.

Surprising Fact

May is designated Hepatitis Awareness Month in the U.S.